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Background: The syphilis diagnostic algorithm in Mozambique consists of a non-treponemal (i.e. RPR) test if laboratory capacity allows or a treponemal rapid test if capacity is insufficient. Implementation of a robust national-level syphilis proficiency testing (PT) program ensures the quality of syphilis serology tests performed.
Objectives: We sought to assist the national reference laboratory at the National Institute of Health (INS), Mozambique in implementing a comprehensive syphilis serology quality assurance program. The project is aimed to strengthen the national laboratory capacity in performing quality syphilis serology testing.
Methods: CDC staff prepared all training materials intended to instruct participants on how to independently create PT panels for the national syphilis RPR PT program and to perform syphilis serologic tests (RPR, TP-PA). CDC staff used Power Point presentations followed by demonstrative hands-on laboratory sessions to train participating INS laboratorians.
Results: All participants (n=5) completed all aspects of training. Post-training, all participants reported they were very confident in their ability to independently prepare PT panels, perform high quality syphilis serologic tests, and implement an RPR PT program in Mozambique. All indicated the training was useful. Syphilis PT panels prepared during the training were shipped to 21 lower-level laboratories with RPR capacity; these laboratories then report results to the INS Reference Laboratory. A follow up evaluation is planned to determine proficiency of RPR testing of staff in the participating laboratories.
Conclusions: The on-site syphilis PT training of national laboratorians in Mozambique was successfully completed. Evaluation of RPR results from the INS Reference Laboratory will indicate areas where further RPR test training is needed. Further studies would be useful in assessing how well the training for national staff supports the PT program in participating laboratories.
Implications for Programs, Policy, and Research: Implementation of the syphilis PT program and further RPR training is a first step in ensuring quality diagnostic testing in Mozambique and eventually other nations.